Developing mental health care of LGBTIQ+ people in Croatia- research review

Introduction Despite the general awareness of necessity for implementing development of competences in working with LGBTIQ+ people as the obligatory course within the education of mental health professionals, it is still not the educational standard in Croatia. Objectives Within the perspective of the past 20 years, the development of educational programs aiming to develop LGBTIQ+ affimrative and informed practice in the field of mental health care, togeather with the review of the most crucial research results in the field of LGBTIQ+ mental health will be given. Methods The results obtained from several research on national samples of LGBTIQ+ people, psychology students and psychologists are analysed using mainly qualitative methodology and to the small extent quantitative methodology. Results Psychologists are perceived as a profession that respects diversity and actively reduces stereotypes and prejudice but there are still some obstacles to overcome within the profession. In traditional cultures appreciation of human rights of LGBT people is unfortunately not a guiding principle. Research on Croatian university students showed that slightly positive attitudes toward LGBT people were stable and remained unchanged from the 2005 till 2013. Specific attitudes toward human rights of lesbians and gays are ranging from moderately negative to moderately positive. The most frequent forms of discrimination and/or violating human rights of LGBT people are: usage of offensive, humiliating, pejorative and oppressive language, ignoring of LGBT people, attentional exclusion of LGBT people, threatening with physical violence. Stress resilience, social support, and inclusion in the LGBT society are key determinants of different indicators of mental health in this population. Although 64.4 % of transgender participants are highly informed about the new legalization, only 24.5 % are very satisfied with it. Trans-women, in comparison to trans-men, have significantly lower levels of quality of life and experience significantly higher levels of sexual violence. Based on the online research among the professionals from the Croatian national list of experts in thefield of health care of trans people the percieved level of transphobia in sociaty is abowe the average, as well as percieved impact of the COVID- 19 pandemic on acessibility and slowing down of standard diagnostic procedures. Conclusions Significant political and social change for sexual and gender minority people in Croatia in the last several years have contributed to a greater public visibility of LGBTIQ+ people. As allies of LGBTIQ+ people and even as belonging to the LGBTIQ+ population, psychologists, psychiatrists and other mental health professionals have the leading role in ensuring that the results of their scientific findings and professional corpus of knowledge have ethical and practical implementation and beneficial impact on society. Disclosure of Interest None Declared

Introduction: Menopause is a special period for women which can have both physical and psychological consequences.Objectives: The aim of our study was to assess the impact of menopause on women's quality of life.Methods: A cross-sectional descriptive study conducted on menopausal women consulting at the basic health center in réjiche over a period from 12 september to 12 october 2022.The impact of menopause on the mental health of women was assessed by the menopause rating scale (MRS).Results: A total of 83 women were incluted in our study.The mean age was 61.89AE11.03years.The median age of menopause was 45 years .The majority of women (90.4%) were married and five women (6%) lived alone.Twenty-six women were professionally active and more than half were sedentary (54.2%).The comorbidities were dominated by arterial hypertension (50.6%).The mean BMI was 30.6AE4.75 Kg/m².All the women had a variable psychological impact (from minor to very strong).The median score of the psychological scale was 10 (13-7): median scores for depressed mood, anxiety and physical and intellectual fatigue equal to 3 (4-1), each and median score for irritability equal to 2 (4-1).Physical and mental fatigue was the most common psychological symptom in 88% of cases followed by irritability in 86.7% of patients.Depressive and anxious symptoms were noted in 85.5% and 84.3% of cases, respectively.Psychological impact was severe in 33.7% of patients (strong or very strong symptoms).Conclusions: Focusing on a small sample of menopausal patients, our study revealed a high prevalence of psychological distress during menopause which requires early adequate assessment and treatment.

EPV1107
Developing mental health care of LGBTIQþ people in Croatia-research review

I. Zegura
Introduction: Despite the general awareness of necessity for implementing development of competences in working with LGBTIQþ people as the obligatory course within the education of mental health professionals, it is still not the educational standard in Croatia.
Objectives: Within the perspective of the past 20 years, the development of educational programs aiming to develop LGBTIQþ affimrative and informed practice in the field of mental health care, togeather with the review of the most crucial research results in the field of LGBTIQþ mental health will be given.Methods: The results obtained from several research on national samples of LGBTIQþ people, psychology students and psychologists are analysed using mainly qualitative methodology and to the small extent quantitative methodology.Results: Psychologists are perceived as a profession that respects diversity and actively reduces stereotypes and prejudice but there are still some obstacles to overcome within the profession.In traditional cultures appreciation of human rights of LGBT people is unfortunately not a guiding principle.Research on Croatian university students showed that slightly positive attitudes toward LGBT people were stable and remained unchanged from the 2005 till 2013.Specific attitudes toward human rights of lesbians and gays are ranging from moderately negative to moderately positive.The most frequent forms of discrimination and/or violating human rights of LGBT people are: usage of offensive, humiliating, pejorative and oppressive language, ignoring of LGBT people, attentional exclusion of LGBT people, threatening with physical violence.Stress resilience, social support, and inclusion in the LGBT society are key determinants of different indicators of mental health in this population.Although 64.4 % of transgender participants are highly informed about the new legalization, only 24.5 % are very satisfied with it.Trans-women, in comparison to trans-men, have significantly lower levels of quality of life and experience significantly higher levels of sexual violence.Based on the online research among the professionals from the Croatian national list of experts in thefield of health care of trans people the percieved level of transphobia in sociaty is abowe the average, as well as percieved impact of the COVID-19 pandemic on acessibility and slowing down of standard diagnostic procedures.Conclusions: Significant political and social change for sexual and gender minority people in Croatia in the last several years have contributed to a greater public visibility of LGBTIQþ people.As allies of LGBTIQþ people and even as belonging to the LGBTIQþ population, psychologists, psychiatrists and other mental health professionals have the leading role in ensuring that the results of their scientific findings and professional corpus of knowledge have ethical and practical implementation and beneficial impact on society.

EPV1108
Postpartum Delirium: A Psychosis Born in the 18th Century J. R. Martins*, R. Vaz, A. L. Costa, J. Brás, R. Sousa, J. Abreu, E. Almeida, R. Andrade, N. Castro and T. Casanova Introduction: Pregnancy and childbirth are moments of great vulnerability in a woman's life, which can predispose her to the development of psychopathology, ranging from transient depressive symptoms ("baby blues") to psychotic symptoms.Postpartum delirium is the psychiatric syndrome that some authors refer to as puerperal psychosis par excellence.It was first described in the 18th century and were thought to be associated with painful delivery, then became rare after the introduction of effective analgesia.Objectives: The objective of this work is to contribute to a better understanding of this condition, through a literature review.Methods: Bibliographic research using Pubmed® and the keywords: postpartum delirium.Results: Clinical presentation of postpartum delirium includes: constantly varying degrees of consciousness; perplexity; hallucinations or pseudo-hallucinations of one or more organs of sense; delusions or delusive-type thoughts; great motoric unrest and considerable motoric and verbal abandon; and acute aggressive discharges can also occur.It is thought to be due to organic complications, such as infectious disease, abnormal loss of blood, thrombosis, neurological disease, obstetric disease, vitamin deficiencies, hormonal changes.An article from 1975 mentions how difficult was to treat postpartum delirium despite the development of psychopharmaceutical therapy.The patients remained psychotic for long periods and had many relapses.They mention a comparative study that found that the symptomatic treatment of this syndrome with a combination of perfenazine and lithium carbonate produced relatively favorable results.For that reason, at that time, it was the medication of choice.Nowadays the psychopharmacological treatment of puerperal psychosis, in general, still consists of the combination of lithium and an antipsychotic, such as haloperidol, and possibly a benzodiazepine, such as lorazepam.Conclusions: Postpartum delirium is rarely mentioned in the literature and just a few cases have been described.It is considered a rare postpartum psychotic condition but would perhaps be less rare if its existence were recognized.On this note, it is important for clinical practice to research on the psychoses of pregnancy and not just the most common.

EPV1109
To what extent does the Tunisian law protect women against violence ?E. Mhiri, M. Maalej*, I. Gassara, R. Feki, N. Smaoui, L. Zouari, J. Ben Thabet, S. Omri, N. Charfi and M. Maalej Introduction: Tunisia, a pioneer in the Arab world in terms of promoting the status of women, has adopted a strategy to combat violence against women and now has a legal arsenal to protect women's rights.Objectives: To study the contribution of the Tunisian jurisdiction in terms of protection of women victims of violence.Methods: A review of the different legal texts, using the key words: "Women", "Violence", "Jurisdiction" and "Protection".Results: *The National Survey on Violence against Women in Tunisia is a long process that involved the efforts of several stakeholders.*In 2011, Tunisia was the first country in the region to have ratified and lifted all specific reservations to CEDAW (Committee on the Elimination of Discrimination Against Women).Violence against women is considered a threat to peace and security.*Secondly, the adoption of Article 46 of the new Constitution of 2014 obligated the State to combat violence against women and make it its priority.*The adoption of Organic Law 58/17 of 11 August 2017 finally gave the status of victim to the abused Woman.This law came into force in 2018.*A number of mechanisms have been put in place, including the establishment of the National Observatory to Combat Violence against Women.*Most magistrates still resist the application of Law 58/17, which contributes to the resurgence of violence against women, especially during periods of slackening of the justice system, such as the COVID lockdown period.Conclusions: Despite the revolutionary legal arsenal acquired for the protection of women in Tunisia, there is still a gap between legislation and practice, and the rate of violence against women continues to increase.Nationwide awareness-raising campaigns aiming to spread awareness among women of their rights are necessary.

EPV1111
Clinical management of psychotic pregnancy denial: what do we know?Case report and narrative review.